What Is Polycystic Ovary Syndrome (PCOS)?

In This Article

Polycystic ovary syndrome (PCOS), which affects about 10% of women of childbearing age, is characterized by irregular menstrual periods, cysts in the ovaries, and overproduction of male hormones. Acne and excessive hair growth are among the noticeable symptoms, and the condition impairs fertility and interferes with metabolic health, including blood glucose levels. The cause isn't completely understood, but obesity and a family history of the condition are known risk factors for developing PCOS.

Knowing the facts about PCOS and what you can do about it can make it easier to live with and prevent long-term complications.

Symptoms

You can experience a variety of symptoms and complications of PCOS, but you might not have all the symptoms. In fact, some women don't have any symptoms and don't realize they have PCOS until complications (like infertility or cancer) emerge.

Common issues with PCOS include:

Complications

Sometimes PCOS leads to issues that don't cause obvious everyday symptoms but can have a substantial effect on your overall health and well being.

It isn't always easy to predict whether you are likely to have complications of PCOS, and having mild symptoms doesn't mean that you will experience more significant health problems.

Consequences of PCOS can include:

Metabolic syndrome is also related to PCOS and increases the risk of heart disease and diabetes.

Fertility and pregnancy can be affected when you have PCOS.

Issues you may experience include:

  • Difficulty getting pregnant
  • Risk of miscarriage
  • Risk of gestational diabetes

Causes

The underlying cause of PCOS is still unknown. Because it runs in families, there are likely genetic factors at work, and research suggests that certain genetic changes may be associated with the condition. Additionally, there are some health and lifestyle factors that appear to raise the risk of PCOS.

Normally, healthy women produce some androgens (male hormones like testosterone). Women who have PCOS produce a higher quantity of androgens than usual. Hormone imbalances, like elevated androgen levels, can affect ovulation, causing irregular, absent, or heavy menstrual periods. Cysts in the ovaries are more likely to develop when a woman has a hormone imbalance, and the cysts can also produce androgens and interfere with regular menstruation.

Ovulation problems go hand-in-hand with irregular periods and can make it harder to become pregnant. And the hormonal problems of PCOS can prevent a healthy pregnancy from progressing, potentially resulting in a miscarriage.

As a woman's hormone production naturally fluctuates throughout life, the effects of PCOS can change as well.

Risk Factors

Experts believe that certain risk factors can lead to PCOS. And inflammation may play a role, although it isn't clear whether PCOS increases inflammation or whether inflammation contributes to PCOS.

Risk factors for developing PCOS:

  • Insulin resistance
  • Obesity
  • Unhealthy eating habits
  • Sedentary lifestyle

Diagnosis

A diagnosis of PCOS can take time. The symptoms of PCOS can also be present with several other medical conditions, so your doctor will assess you to determine which condition you have.

To diagnose PCOS, you will likely need blood tests, a pelvic examination, and imaging tests.

Blood tests can include a measure of your blood glucose, triglyceride, and cholesterol levels.

Additionally, you may have specialized blood tests that measure your hormone levels, including your estrogen, progesterone, testosterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Generally, estrogen, progesterone, LH, and FSH should rise and fall throughout your menstrual cycle, so a one-time measurement is not enough to determine whether you have PCOS. And testosterone would be expected to be higher than normal if you have PCOS, but this might not always be the case

A pelvic examination can help your doctor identify issues like endometriosis or cysts in the cervix or the lower part of your uterus, which can cause symptoms similar to those of PCOS.

Imaging

Imaging tests can identify tumors or structural problems affecting your uterus, ovaries, or any other pelvic structures. You may have a pelvic ultrasound, computerized tomography (CT), or magnetic resonance imaging test (MRI).

An ultrasound of the ovaries may show an enlarged ovary and an increase in the antral follicle count, which is the number of developing eggs in your ovaries. With PCOS, these tiny follicles may appear like a strand of pearls around the ovaries.

Treatment

There is no cure for PCOS, but it can be treated and managed with a combination of lifestyle changes and medications. Strategies like managing hirsutism can also help you gain control of the cosmetic effects of your condition.

Diet and lifestyle changes can be important in managing PCOS.

Steps you can take to reduce the effects of the condition include:

Sometimes, overweight women can experience an improvement in PCOS symptoms with weight loss of 5% or more.

Medication

Prescription medications are often used to manage the hormonal and metabolic alterations of PCOS and to regulate the menstrual cycle. Your need for prescription treatment is directed by your symptoms and your hormone levels.

Medications that may be prescribed for PCOS include:

  • Oral contraceptives
  • Progestin therapy
  • Anti-androgen medications
  • Hormonal treatments like FSH
  • Metformin

Ovulation kits can help as you are trying to become pregnant with PCOS. Medical treatment can also help in the treatment of fertility issues and in the prevention of miscarriages if you become pregnant.

If you plan to become pregnant, it is important that you reach a healthy weight and blood sugar before and during your pregnancy and that you take folic acid supplements as directed by your doctor to reduce the risk of PCOS-related complications.

You may need to see a maternal-fetal medicine specialist for your prenatal care and a dietitian to help you manage your diet and weight.

A Word From Verywell

Learning that you have PCOS can lead to a variety of emotions, from feeling upset to feeling validated that you finally have a name for what's been causing your symptoms. It’s important to give yourself time to adjust as you become familiar with your condition. There are treatments that can help reduce the effects of PCOS. Over time, your medical treatment may need modification as your body's natural phases of hormone production change with age, but the healthy lifestyle habits that help manage PCOS should remain a consistent part of your life.

Learn about PCOS, work closely with your doctor, and set yourself on the best course for successfully managing your condition.

Was this page helpful?
Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. US Department of Health and Human Services. Polycystic ovary syndrome. Updated April 1, 2019.

  2. Mccartney CR, Marshall JC. CLINICAL PRACTICE. Polycystic ovary syndrome. N Engl J Med. 2016;375(1):54-64. doi:10.1056/NEJMcp1514916

  3. He S, Mao X, Lei H, et al. Peripheral blood inflammatory-immune cells as a predictor of infertility in women with polycystic ovary syndromeJ Inflamm Res. 2020;13:441-450. doi:10.2147/JIR.S260770

  4. Saslow LR, Aikens JE. Lifestyle interventions for polycystic ovary syndrome: Cross-sectional survey to assess women's treatment and outcome preferencesJMIR Form Res. 2020;4(9):e17126. doi:10.2196/17126

  5. US Department of Health and Human Services. Does PCOS affect pregnancy? Updated January 31, 2017.

  6. Alves MMC, Almeida M, Oliani AH, Breitenfeld L, Ramalhinho AC. Women with polycystic ovary syndrome and other causes of infertility have a higher prevalence of GSTT1 deletion [published online ahead of print, 2020 Jun 24]. Reprod Biomed Online. 2020;S1472-6483(20)30335-7. doi:10.1016/j.rbmo.2020.06.010

  7. Rosenfield RL. Current concepts of polycystic ovary syndrome pathogenesis. Curr Opin Pediatr. 2020;32(5):698-706. doi:10.1097/MOP.0000000000000945

  8. Rao P, Bhide P. Controversies in the diagnosis of polycystic ovary syndromeTher Adv Reprod Health. 2020;14:2633494120913032. doi:10.1177/2633494120913032

  9. Goodman NF, Cobin RH, Futterweit W, et al. American Association of Clinical Endocrinologists, American College of Endocrinology, and Androgen Excess and PCOS Society disease state clinical review: Guide to the best practices in the evaluation and treatment of polycystic ovary syndrome--Part 1Endocr Pract. 2015;21(11):1291-1300. doi:10.4158/EP15748.DSC